Your next patient is a middle aged man who is at first spraying a fine red mist with each cough, then starts bubbling rivers of bloody goodness with each attempted breath. Your laryngoscope (and hopefully suction and a Bougie) are already in your back pocket. As you go to intubate, is there anything else you can do here?

You can intubate one lung (nonbleeding lung–if you know which one that is)

RIGHT mainstem bronchus is easy — just advance standard ETT.

LEFT mainstemmore difficult – often requires special equipment.

TRY THIS: Rotate tube to the left (90 degrees) after through vocal cords and advance until resistance met.

You can use this for the RIGHT mainstem, too (rotate 90 degrees toward right lung, and advance until resistance)

The rotation technique successfully intubated the right side 94% and the left 72% of the time (n = 25 in cadaver trial)

DISCLAIMER:

This blog is meant as a forum for education and discussion. The information in this blog is meant to be as accurate as possible, however the accuracy or completeness of the information cannot be guaranteed. The contents of this blog should not be interpreted as medical advice for patients, and health care professionals should continue to use their clinical judgement in their daily practice.